The prevalence of Wolff-Parkinson-White syndrome in newborns – results from a large general population study

Abstract Background The accessory electrical pathway in Wolff-Parkinson-White (WPW) syndrome predisposes to tachycardia and may increase risk of sudden cardiac death. Studies investigating the prevalence of this condition in newborns are few. Purpose To describe the prevalence of WPW syndrome and assess the localization of the accessory pathway and associated structural heart disease in newborns from a large general population study. Methods Electrocardiograms (ECG's) and echocardiograms of 17.489 newborns (aged 0–30 days) from a large, prospective general population study were included. WPW cases were identified through manual evaluation of outliers in measurements of PR-interval, QRS-duration, QTcB interval and QRS axis. Newborns suspected for WPW syndrome were offered a secondary echocardiogram and ECG recording. Localization of the accessory pathway was assessed based on a QRS polarity algorithm. The control group consisted of 5,000 randomly selected newborns with a normal echocardiogram. Results Among the 17,489 ECG's we manually analyzed 5,166 and found 15 newborns (80% boys) with WPW syndrome (secondary confirmatory ECG's will be available at ESC 2020) consistent with prevalence of WPW syndrome of 0.1%. The median values of the PR-interval, QRS-duration and QTcB in cases and controls were 80 vs 98 ms, 74 vs 56 ms, and 449 vs 420 ms, respectively (all p<0.0001). The accessory electrical pathway was left-sided in 13 (87%) of the newborns. One newborn had moderate mitral regurgitation while all other newborns had structurally normal hearts and no cases of Ebstein's anomaly. Conclusion The prevalence of WPW syndrome in our cohort was 0.1%. The syndrome was more frequent in boys, and the accessory pathways were mainly left-sided. All but one of the affected newborns had structurally normal hearts. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): This work was supported by the Danish Children Heart Foundation, Snedkermester Sophus Jacobsen and wife Astrid Jacobsen's foundation (Grant 19-R112-A5248-26048), the Research Council at Herlev-Gentofte Hospital and Toyota-Fonden, Denmark.

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The effect of maternal age on the neonatal electrocardiogram – results from a large, prospective population study

European Heart Journal ◽

10.1093/ehjci/ehaa946.3198 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Paerregaard ◽

C Pihl ◽

A Pietersen ◽

K.K Iversen ◽

H Bundgaard ◽

...

Keyword(s):

General Population ◽

Population Study ◽

Maternal Age ◽

Heart Diseases ◽

Significant Proportion ◽

Western World ◽

Funding Source ◽

Electrical System ◽

General Population Study ◽

Wide Range

Abstract Background Congenital heart diseases (CHDs) are the most common type of birth defects and account for a significant proportion of infant mortality. Previous studies have shown an increased prevalence of CHD among children born of women ≥35 years. During the last decades women in the Western world have been giving birth at an increasing age. This might affect the newborns cardiac electrical system. Purpose To investigate the effect of maternal age on the newborns electrocardiogram (ECG). Methods Electrocardiograms from 17,489 newborns (aged 0–30 days) consecutively included in a large, prospective general population study were analyzed. All tracings were acquired digitally and ECG intervals, amplitudes, axis, etc. were automatically analyzed with extensive manual validation. Results Among the 17,489 newborns the median age was 11 days and 52% were boys. The median maternal age was 31 years (range 16–54 years). Dividing the mothers into four age quartiles we had 840 ECG's from newborns with a maternal age between 15–24 years, 12,072 between 25–34 years, 4,525 between 35–44 years, and 52 between 45–54 years. Comparing the youngest and oldest mothers we found the ECG parameters (median values, age group 15–24 vs. 45–54 years) neonatal heart rate (143 vs. 147 beats per minute), PR-interval (98 vs. 96 ms), QRS-duration (54 vs. 56 ms), QT (274 vs. 277 ms), QTcB (419 vs. 423 ms), QRS axis (115 vs. 112 degrees), max V1 R-amplitude (1257 vs. 966μV), max V6 R-amplitude (825 vs. 937μV), max V1 S-amplitude (634 vs. 649 μV) and max V6 S-amplitude (654 vs. 615 μV) were not affected by maternal age (all p>0.05). The same was found when only analyzing the subgroup of newborns aged 0–7 days (all parameters p>0.05). Conclusion We provide data from a large general population study including a wide range of maternal ages. Our findings indicate that maternal age does not affect the newborns hearts electrical system. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): This work was supported by the Danish Children Heart Foundation, Snedkermester Sophus Jacobsen and wife Astrid Jacobsen's foundation (Grant 19-R112-A5248-26048), the Research Council at Herlev-Gentofte Hospital and Toyota-Fonden, Denmark.

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Elevated levels of oxidized nucleosides in individuals with the JAK2V617F mutation from a general population study

Redox Biology ◽

10.1016/j.redox.2021.101895 ◽

2021 ◽

Vol 41 ◽

pp. 101895

Author(s):

Anders L. Sørensen ◽

Hans C. Hasselbalch ◽

Mads Emil Bjørn ◽

Claus H. Nielsen ◽

Sabrina Cordua ◽

...

Keyword(s):

General Population ◽

Population Study ◽

Jak2v617f Mutation ◽

General Population Study

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Natural history of the electrical axis during the first four weeks of life

European Heart Journal ◽

10.1093/ehjci/ehaa946.3199 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Paerregaard ◽

J Kock ◽

C Pihl ◽

A Pietersen ◽

K.K Iversen ◽

...

Keyword(s):

Heart Disease ◽

Heart Diseases ◽

Structural Heart Disease ◽

Funding Source ◽

Axis Deviation ◽

General Population Study ◽

Gestation Age ◽

History Of ◽

The Right ◽

Heart Foundation

Abstract Background The QRS axis represents the sum of the amplitudes and orientation of the ventricular depolarization. In newborns, the QRS axis is generally directed downward and to the right and left axis deviation (LAD) may be associated with heart disease. Accurate interpretation of abnormalities in the QRS axis may facilitate early diagnosis of heart diseases in newborns. Purpose To describe the evolution of the QRS axis during the first four weeks of life and provide updated, digitalized, normal values from healthy newborns. Methods Electrocardiograms from 12,317 newborns (age 0–28 days) included in a regional, prospective, general population study from 2016–2018 were analyzed. Electrocardiograms were obtained and analyzed with a computerized algorithm with manual validation. The algorithm calculated the QRS mean axis using the net amplitudes of three leads I, II, and III. The four main QRS axis classifications were: “adult normal” axis (+1° to +90°), left axis deviation (LAD, 0° to −90°), right axis deviation (RAD, +91° to +180°), and extreme axis deviation (EAD, +181° to +270°). Echocardiograms were performed according to standard guidelines. Only newborns with an echocardiography excluding structural heart disease were included. Results Electrocardiograms from 12,317 newborns with a median age at examination of 12 days (52% boys) were included. The median QRS axis was 119° at the ages 0–7 days and shifted leftwards to 102° at the ages 22–28 days (p<0.001). We found that girls had significant less pronounced right axis deviation than boys (111° vs 117°, p<0.001) and that increasing gestational age was associated with more pronounced right axis deviation (104° vs 116°, p<0.05). Infant size did not affect the axis (p>0.05). Only 0.5% had LAD (0° to −90°) and 1.1% had an axis within the interval +240° to +30° indicating that a QRS axis in this expanded interval is unusual in healthy newborns. Conclusion The QRS axis showed a gradual leftward-shift during the first four weeks of life and was affected by sex and gestation age but unaffected by infant size. LAD occurred in only 0.5% of the newborns. Our data serve as updated reference values, which may facilitate clinical handling of newborns. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): This work was supported by the Danish Children Heart Foundation, Snedkermester Sophus Jacobsen and wife Astrid Jacobsen's foundation (Grant 19-R112-A5248-26048), the Research Council at Herlev-Gentofte Hospital and Toyota-Fonden, Denmark.

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Childhood negative experiences and subclinical psychosis in adolescence: a longitudinal general population study

Early Intervention in Psychiatry ◽

10.1111/j.1751-7893.2007.00027.x ◽

2007 ◽

Vol 1 (2) ◽

pp. 201-207 ◽

Cited By ~ 22

Author(s):

Ellen De Loore ◽

Marjan Drukker ◽

Nicole Gunther ◽

Frans Feron ◽

Dirk Deboutte ◽

...

Keyword(s):

General Population ◽

Population Study ◽

General Population Study ◽

Negative Experiences ◽

Subclinical Psychosis

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Association of Blood Eosinophil and Blood Neutrophil Counts with Asthma Exacerbations in the Copenhagen General Population Study

Clinical Chemistry ◽

10.1373/clinchem.2016.267450 ◽

2017 ◽

Vol 63 (4) ◽

pp. 823-832 ◽

Cited By ~ 19

Author(s):

Signe Vedel-Krogh ◽

Sune Fallgaard Nielsen ◽

Peter Lange ◽

Jørgen Vestbo ◽

Børge Grønne Nordestgaard

Keyword(s):

General Population ◽

Disease Severity ◽

Population Study ◽

Blood Eosinophil ◽

Blood Neutrophil ◽

General Population Study ◽

Asthma Exacerbations ◽

Increased Risk ◽

Blood Neutrophils ◽

Eosinophil Counts

Abstract BACKGROUND Blood eosinophil count is a marker of eosinophilic airway inflammation and disease severity in asthma. However, blood neutrophil count might also be associated with disease severity. We tested the hypothesis that high blood eosinophil and neutrophil counts are both associated with the risk of asthma exacerbations among individuals with asthma from the general population. METHODS From the Copenhagen General Population Study with 81351 participants, we included 4838 with self-reported asthma. We recorded baseline blood eosinophil and neutrophil counts, and asthma exacerbations during follow-up in 2003–2011, defined as moderate (short-course treatment of prednisolone) or severe (hospitalization). RESULTS The multivariable-adjusted incidence rate ratios (IRRs) were 1.28 (95% CI, 1.06–1.55) for moderate exacerbations and 1.55 (1.20–2.00) for severe exacerbations for individuals with blood eosinophil counts >0.29 × 109/L (highest tertile) vs individuals with blood eosinophil counts <0.18 × 109/L (lowest tertile). For blood neutrophils, the multivariable-adjusted IRRs were 2.14 (1.74–2.63) for moderate exacerbations and 1.18 (0.89–1.55) for severe exacerbations for individuals with blood neutrophil counts >4.85 × 109/L (highest tertile) vs individuals with blood neutrophil counts <3.77 × 109/L (lowest tertile). Blood eosinophil and neutrophil counts interacted on moderate exacerbations (P = 3 × 10−4), but not on severe exacerbations. CONCLUSIONS High blood eosinophil counts are associated with an increased risk of both moderate and severe asthma exacerbations, while high blood neutrophil counts are associated with an increased risk of moderate, but not severe exacerbations.

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From Epidemiology to Daily Life: Linking Daily Life Stress Reactivity to Persistence of Psychotic Experiences in a Longitudinal General Population Study

PLoS ONE ◽

10.1371/journal.pone.0062688 ◽

2013 ◽

Vol 8 (4) ◽

pp. e62688 ◽

Cited By ~ 41

Author(s):

Dina Collip ◽

Johanna T. W. Wigman ◽

Inez Myin-Germeys ◽

Nele Jacobs ◽

Catherine Derom ◽

...

Keyword(s):

General Population ◽

Population Study ◽

Life Stress ◽

Stress Reactivity ◽

Daily Life ◽

Psychotic Experiences ◽

General Population Study

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Increased Risk for Other Cancers in Addition to Breast Cancer for CHEK2*1100delC Heterozygotes Estimated From the Copenhagen General Population Study

Journal of Clinical Oncology ◽

10.1200/jco.2015.63.3594 ◽

2016 ◽

Vol 34 (11) ◽

pp. 1208-1216 ◽

Cited By ~ 50

Author(s):

Charlotte Näslund-Koch ◽

Børge G. Nordestgaard ◽

Stig E. Bojesen

Keyword(s):

Breast Cancer ◽

General Population ◽

Population Study ◽

Cell Cycle Checkpoint ◽

Loss Of Function ◽

General Population Study ◽

Chek2 1100Delc ◽

Hazard Ratios ◽

Increased Risk ◽

Age And Sex

Purpose CHEK2 is a cell cycle checkpoint regulator, and the CHEK2*1100delC germline mutation leads to loss of function and increased breast cancer risk. It seems plausible that this mutation could also predispose to other cancers. Therefore, we tested the hypothesis that CHEK2*1100delC heterozygosity is associated with increased risk for other cancers in addition to breast cancer in the general population. Patients and Methods We examined 86,975 individuals from the Copenhagen General Population Study, recruited from 2003 through 2010. The participants completed a questionnaire on health and lifestyle, were examined physically, had blood drawn for DNA extraction, were tested for presence of CHEK2*1100delC using Taqman assays and sequencing, and were linked over 1943 through 2011 to the Danish Cancer Registry. Incidences and risks of individual cancer types, including breast cancer, were calculated using Kaplan-Meier estimates, Fine and Gray competing-risks regressions, and stratified analyses with interaction tests. Results Among 86,975 individuals, 670 (0.8%) were CHEK2*1100delC heterozygous, 2,442 developed breast cancer, and 6,635 developed other cancers. The age- and sex-adjusted hazard ratio for CHEK2*1100delC heterozygotes compared with noncarriers was 2.08 (95% CI, 1.51 to 2.85) for breast cancer and 1.45 (95% CI, 1.15 to 1.82) for other cancers. When stratifying for sex, the age-adjusted hazard ratios for other cancers were 1.54 (95% CI, 1.08 to 2.18) for women and 1.37 (95% CI, 1.01 to 1.85) for men (sex difference: P = .63). For CHEK2*1100delC heterozygotes compared with noncarriers, the age- and sex-adjusted hazard ratios were 5.76 (95% CI, 2.12 to 15.6) for stomach cancer, 3.61 (95% CI, 1.33 to 9.79) for kidney cancer, 3.45 (95% CI, 1.09 to 10.9) for sarcoma, and 1.60 (95% CI, 1.00 to 2.56) for prostate cancer. Conclusion CHEK2*1100delC heterozygosity is associated with 15% to 82% increased risk for at least some cancers in addition to breast cancer. This information may be useful in clinical counseling of patients with this loss-of-function mutation.

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